Healthcare Analyst QM
- Creates and maintains the Provider Monitoring Medical Audit calendar
- Accountable for ordering audit samples from the appropriate resources and notifying the providers of upcoming audits
- Converts the results of data analysis into meaningful business information and understandable charts or data
- Order and or prepare samples 45 days prior to audit start date. If sample is not available send a request to the provider for the current roster in a timely manner
- Send provider audit notifications 30 days prior to audit start date. Special requests and Ad-hoc audits are also delivered in a timely manner.
- Make necessary changes to calendar within 24 hours of notification
- Track audit completions and ensure results are complete
- Reports Processes and evaluates complex data and information sets.
- Converts the results of data analysis into meaningful business information.
- Create clear, understandable charts or data.
- Prepare and submit reports within 24 hours of request
- Maintain PIP/CAP database for Provider Monitoring audit PIPs, CAPs, and individual provider PIPs/CAPs
- Need to be competent with developing data sheets and databases, highly organized, multi-tasker
COVID-19 Vaccination Requirement
CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated.
You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.
- Experience in Behavioral Health and/or Physical health
Bring your heart to CVS Health
Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver.
Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.
We strive to promote and sustain a culture of diversity, inclusion and belonging every day.
CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.